Advocates of cheaper medicines feel that they are now in the homestretch. A bicameral conference committee will be meeting during the next few days to thresh out the remaining differences between the Senate and House versions of the Cheaper Medicines Act.

It is reported that only two major sticking points are still to be resolved but that the two panels are very close to agreement even on these. The House proposal to create a Price Regulatory Board for Medicines is likely to be reformulated into a provision that mandates the Department of Health (with approval of the President) to promulgate price ceilings on specific medicines based on pressing public health considerations. Such a determination should be made through broad-based consultations with as many stakeholders as possible. This is entirely consistent with the Doha Declaration placing public health needs above commercial considerations in the implementation of international agreements on intellectual property.

The provision strengthening the Generics Law of 1988 by requiring doctors to write only the generic names of medicines on their prescriptions had brought on a big outcry from doctors. While many of the protesters voiced hysterical fears of infringement on the powers of physicians, academic groups such as the Philippine College of Physicians soberly pointed out the real dangers of "generics only" prescribing in the absence of mechanisms to assure quality and safety of drugs in the market.

On the other hand, advocates of affordable access to medicines believe that the severe hardships on poor people brought on by current marketing strategies of drug-makers far outweighed the risks of proliferating low quality preparations. The conditions required for ensuring drug safety and effectiveness, they countered, were doable and well within the capability not only of DOH and the BFAD but also of a watchful civil society.

As in the case of price control, the differences between House and Senate versions on this issue are not insurmountable. A possible compromise would be provide a mandate to DOH to propose a reasonable time line for developing the implementing rules in an open and transparent process before implementing the generics only provision.

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This month, the National Kidney and Transplant Institute will mark its 25th anniversary of service to Filipinos who suffer from kidney disease. The Institute is one of the most successful of the high technology tertiary care facilities set up under the regime of President Ferdinand Marcos. Once derided as one of the "disease palaces" created by Mrs. Marcos’ "imeldific" mind, the Institute has not only thrived as a center of excellence for the treatment of renal dialysis and transplantation but has also become a focal point in the development of leading edge biotechnological applications to the treatment of such dreaded diseases as cancer.

But it is still in the field of kidney transplants as the ultimate treatment of end stage renal disease that the Kidney Institute has made its mark locally and internationally. Locally, it has helped to develop similar centers in various regions of the country. Internationally, the quality of its work is recognized as among the best in the world in terms of numbers of patients, survival rates, and technical proficiency of its staff. In the context of the ethical issues surrounding the use of living non-related donated kidneys for transplantation, the National Kidney Institute is unique in that it has followed all guidelines scrupulously – including limiting the number of rich foreign beneficiaries to ten percent of the total procedures done annually.

In this regard, it must be noted that the continued unabated unethical commerce in harvesting kidneys from poor Filipinos for transplantation to rich foreigners is reaching alarming proportions. The DOH administrative order on this issue has been expected for some time but, with the administration’s demonstrated weakness on social issues like this, there are no great expectations that such an order would be effective. It is hoped that the sterling 25-year record of the National Kidney and Transplant Institute will inspire both its mother agency, the DOH, and its many other stakeholders to take strong measures to prevent a Philippine version of what recently transpired in India where poor workers were forced to give up their kidneys to a ghoulish "surgeon" practicing a thriving foreign trade in body parts.

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In his inaugural speech as the 7th president of the Pamantasan ng Lungsod ng Maynila (or the University of the City of Manila) last month, Adel Abbas Tamano referred to the close link between heroism and education as one of country’s hopes for emerging from its present deadly cycle of poverty, ignorance, and disease. Attorney Tamano’s references to Jose Rizal as model for educators and students alike took on a more contemporary meaning last week in the person of a self-described "unlikely hero" – Jun Lozada, now of PNP abduction and ZTE fame.

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